Private Client Inquiry Form

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Contact Information

First Name

Last Name

Email Address

Mobile Number

Session Details

1. What type of session are you interested in? (Check all that apply)

Sound Bath

Guided Meditation

Yoga Nidra / NSDR

Yoga

Combination Session

Not sure yet

2. Is this session for:

Yourself

A small group

A special occasion (birthday, gathering, retreat, etc.)

3. Estimated number of participants

4. Preferred session length

30 minutes

45 minutes

60 minutes

Open to recommendation

Location

1. Where would the session take place?

Private home

Outdoor space

Rented studio

Other (please specify)

2. City

3. State

Intentions

1. What are you hoping this session will support?

2. Have you or anyone attending worked with sound healing or meditation before?

Yes

Some Experience

Timing

1. Preferred date or timeframe

mm-dd-yyyy

2. Preferred time of day

Morning

Afternoon

Evening

Flexible

Is there anything else you’d like me to know before connecting?

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